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Efficacy and safety of mesenchymal stromal cells for the prophylaxis of chronic graft-versus-host disease after allogeneic hematopoietic stem cell transplantation: a meta-analysis of randomized controlled trials

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Abstract

A meta-analysis of randomized controlled trials (RCTs) was conducted to evaluate the efficacy and safety of mesenchymal stromal cells (MSCs) for the prophylaxis of chronic graft-versus-host disease (cGVHD) in patients with hematological malignancies undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT). Six studies involving 365 patients were included. The pooled results showed that MSCs significantly reduced the incidence of cGVHD (risk ratio [RR] 0.63, 95% confidence interval [CI] 0.46 to 0.86, P = 0.004). Favorable prophylactic effects of MSCs on cGVHD were observed with umbilical cord-derived, high-dose, and late-infusion MSCs, while bone marrow-derived, low-dose, and coinfused MSCs did not confer beneficial prophylactic effects. In addition, MSC infusion did not increase the risk of primary disease relapse and infection (RR 1.02, 95% CI 0.70 to 1.50, P = 0.913; RR 0.89, 95% CI 0.44 to 1.81, P = 0.752; respectively). Moreover, there was an apparent trend toward increased overall survival (OS) in the MSC group compared with that in the control group (RR 1.13, 95% CI 0.98 to 1.29, P = 0.084). In conclusion, this meta-analysis demonstrated that MSC infusion is an effective and safe prophylactic strategy for cGVHD in patients with hematological malignancies undergoing allo-HSCT.

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Funding

This study was supported by the National Natural Science Foundation of China (nos. 81270642 and 81070451), the Beijing Natural Science Foundation (no. 7162175), the Hainan Social Development Special Funding (no. SF201306), the Four Hundreds Program of Chinese PLA General Hospital (no. YS201451), and the Military Logistics Program (no. cjn15j001).

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  1. Li Wang, Cheng-ying Zhu and De-xun Ma contributed equally to this work.

Authors and Affiliations

  1. Department of Hematology, Laoshan Branch of No. 401 Hospital of Chinese People’s Liberation Army (PLA), 109 Laoshan Road, Qingdao, 266101, China

    Li Wang, De-xun Ma, Chang-chun Xu, Ji-gang Chen, Cheng-jun Liu, Rui Gao, Du-jun Zhuo & Shu-feng Liu

  2. Department of Hematology, Chinese People’s Liberation Army (PLA) General Hospital, 28 Fuxing Road, Beijing, 100853, China

    Li Wang, Cheng-ying Zhu, Zhen-yang Gu, Fei-yan Wang, Li-xun Guan, Zhe Gao, Shu Fang & Chun-ji Gao

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Wang, L., Zhu, Cy., Ma, Dx. et al. Efficacy and safety of mesenchymal stromal cells for the prophylaxis of chronic graft-versus-host disease after allogeneic hematopoietic stem cell transplantation: a meta-analysis of randomized controlled trials. Ann Hematol 97, 1941–1950 (2018). https://doi.org/10.1007/s00277-018-3384-8

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